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Pediatric Review

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https://www.readbyqxmd.com/read/28340029/the-proportion-of-errors-in-medical-prescriptions-and-their-executions-among-hospitalized-children-before-and-during-accreditation
#1
Tal Margalit Mekory, Hilla Bahat, Benjamin Bar-Oz, Orna Tal, Matitiahu Berkovitch, Eran Kozer
Objective: To evaluate the rate of medication related errors in the pediatric ward and pediatric emergency department (PED), before and after implementing intervention strategies according to the Joint Commission International (JCI) accreditation program. Design: A retrospective cross-sectional study that included chart review. Setting: A university affiliated pediatric ward and PED. Participants: Children 0-18 years old admitted on February 2013 (before the JCI program) and February 2014 (during implementation of the JCI program)...
March 10, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339675/high-reported-rates-of-antimicrobial-resistance-in-indian-neonatal-and-pediatric-blood-stream-infections
#2
Dhanya Dharmapalan, Anita Shet, Vijay Yewale, Mike Sharland
Background.: There is real shortage of national data on antimicrobial resistance rates in Indian neonates and children. A descriptive review was conducted to determine the patterns of antimicrobial resistance in isolates of blood stream infection among hospitalized children in India. Methods.: Published and gray literature on antibiotic resistance in children was searched using "Google Scholar", "Scopus", and "PubMed" databases between January 2000 and July 2015...
February 18, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28339428/does-conservative-treatment-change-the-brain-in-patients-with-chronic-musculoskeletal-pain-a-systematic-review
#3
Jeroen Kregel, Iris Coppieters, Robby DePauw, Anneleen Malfliet, Lieven Danneels, Jo Nijs, Barbara Cagnie, Mira Meeus
BACKGROUND: Chronic musculoskeletal pain is characterized by maladaptive central neuroplastic changes. Many observational studies have demonstrated that chronic pain states are associated with brain alterations regarding structure and/or function. Rehabilitation of patients with chronic musculoskeletal pain may include cognitive, exercise, or multimodal therapies. OBJECTIVE: The current review aims to provide a constructive overview of the existing literature reporting neural correlates, based on brain magnetic resonance imaging (MRI) techniques, following conservative treatment in chronic musculoskeletal pain patients...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28338594/the-association-of-non-accidental-trauma-with-historical-factors-exam-findings-and-diagnostic-testing-during-the-initial-trauma-evaluation
#4
Mauricio A Escobar, Marc Auerbach, Katherine Flynn-O'Brien, Gunjan Tiyyagura, Matthew A Borgman, Susan J Duffy, Kelly Falcone, Rita Burke, John M Cox, Sabine Maguire
Early identification of non-accidental trauma (NAT) is a critical component of pediatric trauma care. Literature searches were conducted related to the association of NAT with seven key areas: history, exam findings (burns, oral trauma, bruising) and imaging (fractures, abdominal and brain injuries). When available, odds ratios (OR) with 95% confidence intervals (CI) for associations with NAT are presented. Systematic reviews have been published in six of the seven key areas and are described. The operational definition of NAT was widely variable across studies, prohibiting meta-analysis...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338568/pediatric-patient-with-renal-cell-carcinoma-treated-by-successive-antiangiogenics-drugs-a-case-report-and-review-of-the-literature
#5
Irene Jiménez, Hervé J Brisse, Paul Fréneaux, Sabine Sarnacki, Jean Michon, Daniel Orbach, Gaelle Pierron, Nathalie Clément, François Doz, Bernard Escudier, Gudrun Schleiermacher
Antiangiogenic drugs are currently standard of care in adults with renal cell carcinoma (RCC), including translocation RCC. Although antitumor activity and toxicity profile are well known in adults, few data have been reported in children. Here we present the case of a patient diagnosed at 2 years old with a metastatic translocation RCC, consecutively treated with 5 tyrosine kinase inhibitors during 6 years. The antitumor activity and toxic effects are described, and a brief review of the literature is presented...
March 23, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28338487/the-evolution-of-disease-chronic-lung-disease-of-infancy-and-pulmonary-hypertension
#6
Michael C Tracy, David N Cornfield
PURPOSE OF REVIEW: Bronchopulmonary dysplasia (BPD) or chronic lung disease of infancy BPD was originally described 50 years ago, in 1967 by Northway et al. This article possesses two fundamental objectives to provide: a brief historical perspective on BPD; and an update relative to current notions of epidemiology, pathophysiology, evaluation, and clinical management of BPD complicated by vascular disease. The review highlights areas of consensus and ongoing uncertainty. RECENT FINDINGS: The clinical cause and presentation of infants with BPD has evolved over the past several decades...
March 23, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28338446/the-use-of-hippocampal-volumetric-measurements-to-improve-diagnostic-accuracy-in-pediatric-patients-with-mesial-temporal-sclerosis
#7
Gloria J Guzmán Pérez-Carrillo, Christopher Owen, Katherine E Schwetye, Spencer McFarlane, Ananth K Vellimana, Soe Mar, Michelle M Miller-Thomas, Joshua S Shimony, Matthew D Smyth, Tammie L S Benzinger
OBJECTIVE Many patients with medically intractable epilepsy have mesial temporal sclerosis (MTS), which significantly affects their quality of life. The surgical excision of MTS lesions can result in marked improvement or even complete resolution of the epileptic episodes. Reliable radiological diagnosis of MTS is a clinical challenge. The purpose of this study was to evaluate the utility of volumetric mapping of the hippocampi for the identification of MTS in a case-controlled series of pediatric patients who underwent resection for medically refractory epilepsy, using pathology as a gold standard...
March 24, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28338364/indications-risk-of-lower-airway-infection-and-complications-to-pediatric-tracheotomy-report-from-a-tertiary-referral-center
#8
Christian Grønhøj, Birgitte Charabi, Christian von Buchwald, Thomas Hjuler
BACKGROUND: Although pediatric tracheotomy is potentially life-saving, the procedure is associated with high risk of complications, and indications have changed the last decade. We report indications, complications, and lower airway infections (LAIs) to pediatric tracheotomy performed at a tertiary referral center. METHODS: We identified all children (<18 years) who underwent tracheotomy at our institution during 2008-2015. A review of hospital records was performed to extract data on indication of the procedure, complications, and information on pre- and postoperative LAI...
March 24, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28338185/a-structured-blood-conservation-program-in-pediatric-cardiac-surgery
#9
A B Budak, K McCusker, S Gunaydin
OBJECTIVE: The limitation of alternative transfusion practices in infants increases the benefits of blood conservation. We analyzed the efficacy of a structured program to reduce transfusions and transfusion-associated complications in cardiac surgery PATIENTS AND METHODS: Our pediatric surgery database was reviewed retrospectively, comparing outcomes from two different time periods, after the implementation of an effective blood conservation program beginning in March 2014. A total of 214 infants (8...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28337080/vancomycin-auc-mic-and-corresponding-troughs-in-a-pediatric-population
#10
Omayma A Kishk, Allison B Lardieri, Emily L Heil, Jill A Morgan
OBJECTIVES: Adult guidelines suggest an area under the curve/minimum inhibitory concentration (AUC/MIC) > 400 corresponds to a vancomycin trough serum concentration of 15 to 20 mg/L for methicillin-resistant Staphylococcus aureus infections, but obtaining these troughs in children are difficult. The primary objective of this study was to assess the likelihood that 15 mg/kg of vancomycin every 6 hours in a child achieves an AUC/MIC > 400. METHODS: This retrospective chart review included pediatric patients >2 months to <18 years with a positive S aureus blood culture and documented MIC who received at least two doses of vancomycin with corresponding trough...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28337077/antithrombin-iii-doses-rounded-to-available-vial-sizes-in-critically-ill-pediatric-patients
#11
Winifred M Stockton, Eimeira Padilla-Tolentino, Carolyn E Ragsdale
OBJECTIVES: Children have decreased levels of antithrombin III (AT III) compared to adults. These levels may be further decreased during acute illness. Administration of exogenous AT III can increase anticoagulant efficacy. The objective of this study was to evaluate AT III doses rounded to available vial sizes compared to partial vial doses in critically ill pediatric patients, including patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28336302/-vasopressors-and-inotropes-use-in-pediatrics
#12
Adrián García-Canales, Rocío Alejandra Peña-Juárez, Luz de María Sandoval-Franco
The cardiovascular system is a dynamic system whose function is to ensure adequate delivery of oxygen, nutrients and hormones to the tissues, necessary for cell metabolism, also synthesizes and modifies vasoactive components to regulate vascular tone and myocardial function. These components have become critical in the management of pediatric patients in critical condition with heart failure and shock which has proven its beneficial effects, however its use and abuse brings harmful effects, increase mortality, associated with arrhythmias and increase myocardial oxygen consumption favoring the presence of ischemia, therefore is necessary to know the mechanism of action and indications of these drugs to minimize the harmful effects...
March 20, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28336237/point-of-care-ultrasound-sonographic-posterior-fat-pad-sign-a%C3%A2-case-report-and-brief-literature-review
#13
Yoshito Okumura, Nestor Maldonado, Kyle Lennon, Bryan McCarty, Philipp Underwood, Mathew Nelson
BACKGROUND: Diagnosis of elbow fracture can sometimes be difficult with plain radiography due to overlapping bones, growth plates, and maturing bones in the pediatric population. The radiographic posterior fat pad (PFP) sign is one of the frequently referenced indirect signs of an occult elbow fracture. This sign can be falsely negative if the sign is subtle, and can be falsely positive when the position of the elbow is not flexed at 90 degrees. CASE REPORT: We discuss a case in which sonographic PFP sign helped to diagnose an elbow fracture...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336156/pediatric-arterial-ischemic-stroke-epidemiology-risk-factors-and-management
#14
Ryan J Felling, Lisa R Sun, Emily C Maxwell, Neil Goldenberg, Timothy Bernard
Pediatric arterial ischemic stroke (AIS) is an uncommon but important cause of neurologic morbidity in neonates and children, with consequences including hemiparesis, intellectual disabilities, and epilepsy. The causes of pediatric AIS are unique to those typically associated with stroke in adults. Familiarity with the risk factors for AIS in children will help with efficient diagnosis, which is unfortunately frequently delayed. Here we review the epidemiology and risk factors for AIS in neonates and children...
March 7, 2017: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/28336027/reducing-surgery-cancellations-at-a-pediatric-ambulatory-surgery-center
#15
Chelsea M Lee, Cheryl Rodgers, Albert K Oh, Virginia C Muckler
Surgery cancellations are costly and can be frustrating for patients, their families, and the surgical team. Because of the inherent nature of an ambulatory surgery center, which only performs scheduled elective procedures, surgical cancellations typically result in wasted time and resources. Pediatric surgery cancellations can be mitigated with proper preoperative screening and communication between nurses and patients' guardians. To reduce the rate of cancellation at our pediatric ambulatory surgery center, we implemented a Nurse-Patient Preoperative Call Log...
April 2017: AORN Journal
https://www.readbyqxmd.com/read/28336016/review-of-issues-and-challenges-of-practicing-emergency-medicine-above-30-000-feet-altitude-2-anonymized-cases
#16
Kam Lun Hon, Karen Ka Yan Leung
We present 2 anonymized cases to identify issues and challenges associated with long-haul in-flight medical emergencies. The first case involved a middle-aged man with a history of carditis on a systemic steroid who developed vomiting and rigor. Four physicians, including a pediatric intensivist, responded to the emergency call. In the second case, a pediatric trainee who was the only onboard medical personnel was summoned for help when a middle-aged man developed acute shortness of breath while traveling on a commercial flight...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28335872/cognitive-impairment-in-euthymic-pediatric-bipolar-disorder-a-systematic-review-and-meta-analysis
#17
REVIEW
Liana R Elias, Kamilla W Miskowiak, Antônio M O Vale, Cristiano A Köhler, Hanne L Kjærstad, Brendon Stubbs, Lars V Kessing, Eduard Vieta, Michael Maes, Benjamin I Goldstein, André F Carvalho
OBJECTIVE: To perform a systematic review and meta-analysis of studies investigating neurocognition in euthymic youths with bipolar disorder (BD) compared to healthy controls (HCs). METHOD: A systematic literature search was conducted in the PubMed/MEDLINE, PsycINFO, and EMBASE databases from inception up until March 23, 2016, for original peer-reviewed articles that investigated neurocognition in euthymic youths with BD compared to HCs. Effect sizes (ES) for individual tests were extracted...
April 2017: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28335827/management-of-acute-respiratory-diseases-in-the-pediatric-population-the-role-of-oral-corticosteroids
#18
REVIEW
Renato Cutrera, Eugenio Baraldi, Luciana Indinnimeo, Michele Miraglia Del Giudice, Giorgio Piacentini, Francesco Scaglione, Nicola Ullmann, Laura Moschino, Francesca Galdo, Marzia Duse
Respiratory diseases account for about 25% of all pediatric consultations, and 10% of these are for asthma. The other main pediatric respiratory diseases, in terms of incidence, are bronchiolitis, acute bronchitis and respiratory infections. Oral corticosteroids, in particular prednisolone, are often used to treat acute respiratory diseases given their anti-inflammatory effects. However, the efficacy of treatment with oral corticosteroids differs among the various types of pediatric respiratory diseases. Notably, also the adverse effects of corticosteroid treatment can differ depending on dosage, duration of treatment and type of corticosteroid administered - a case in point being growth retardation in long-course treatment...
March 23, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28334588/applying-the-chronic-care-model-to-improve-care-and-outcomes-at-a-pediatric-medical-center
#19
Jennifer Lail, Pamela J Schoettker, Denise L White, Bhavna Mehta, Uma R Kotagal
BACKGROUND: Cincinnati Children's Hospital Medical Center launched the Condition Outcomes Improvement Initiative in 2012 to help disease-based teams use the principles of improvement science to implement components of the Chronic Care Model and improve outpatient care delivery for populations of children with chronic and complex conditions. The goal was to improve outcomes by 20% from baseline. METHODS: Initiative activities included review of the evidence to choose and measure outcomes, development of condition-specific patient registries and tools for data collection, patient stratification, planning and coordinating care before and after visits, and self-management support...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334565/year-end-resident-clinic-handoffs-narrative-review-and-recommendations-for-improvement
#20
Amber T Pincavage, Michael J Donnelly, John Q Young, Vineet M Arora
BACKGROUND: Year-end clinic handoffs in resident continuity clinics are an important patient safety issue. METHODS: Intervention articles addressing the year-end resident clinic handoff were identified in a targeted literature search. These articles were reviewed and abstracted to summarize the current literature. On the basis of these reviews and consensus expert opinion, recommendations to improve year-end clinic handoffs were developed. RESULTS: Of 23 identified articles, 10 intervention articles in the fields of internal medicine, internal medicine-pediatrics, psychiatry, and family medicine were ultimately included...
February 2017: Joint Commission Journal on Quality and Patient Safety
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